BILL ANALYSIS
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THIRD READING
Bill No: SB 566
Author: Escutia (D), et al
Amended: 1/26/00
Vote: 21
SENATE HEALTH & HUMAN SERV. COMMITTEE : 6-2, 4/14/99
AYES: Escutia, Figueroa, Hughes, Polanco, Solis,
Vasconcellos
NOES: Haynes, Mountjoy
NOT VOTING: Morrow
SENATE INSURANCE COMMITTEE : 6-1, 1/5/00
AYES: Speier, Escutia, Figueroa, Hughes, Johnston, Sher
NOES: Leslie
NOT VOTING: Johnson, Lewis, Schiff
SENATE APPROPRIATIONS COMMITTEE : 7-5, 1/26/00
AYES: Johnston, Alpert, Bowen, Burton, Escutia, Perata,
Vasconcellos
NOES: Johnson, Kelley, Leslie, McPherson, Mountjoy
NOT VOTING: Karnette
SUBJECT : School health centers
SOURCE : Los Angeles Unified School District
DIGEST : This bill creates the School Health Center Grant
Program (DHS), under which grants shall be made to
qualifying school health centers to assist them in
delivering health services to students. Requires the State
Department of Health Services to administer the grant
CONTINUED
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program; however, it would not become operative unless
funds for its purposes are appropriated in the Budget Act.
Furthermore, this bill requires DHS to establish a study
group to explore long-term strategies for the support of
school health centers.
ANALYSIS : This bill:
1.Establishes the School Health Center Grant Program,
administered by the Director of DHS, to offer grants to
"qualifying school health centers" for the purpose of
assisting those centers in delivering health services to
students.
2.Defines a qualifying school health center as a school
health center that does both of the following:
A. Establishes policies and procedures to ensure
compliance with all legal requirements regarding
parental consent for providing medical care to minors.
B. Establishes methods of promoting enrollment of
eligible students in the Medi-Cal program.
3.Provides that the above provisions shall only become
operative if funds are appropriated in the annual Budget
Act.
4.Requires the DHS to establish a study group to explore
long-term strategies for the support of school health
centers and the director of DHS to appoint
representatives from: (1) the Managed Risk Medical
Insurance Board, (2) the Medi-Cal program, (3) the
Department of Education, (4) the Department of Mental
Health (5) community clinics, (6) managed care and (7)
school health centers. Requires the study group to
report its findings to the health and education
committees of the Legislature by January 1, 2002.
Comments :
Research provided to the Senate Insurance Committee
indicates that School-Based Health Centers (SBHC) improve
access of health care to adolescent youth, particularly
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young males. Studies indicate SBHCs are particularly
successful in improving access to and treatment for mental
health and substance abuse problems.
Many states have made efforts to coordinate SBHC services
with managed care services. Michigan, Connecticut and
Rhode Island require managed care plan contracting with
SBHCs while most other states simply encourage this type of
linkage.
In California, over 90 SBHCs serve 11 regions and provide a
variety of services ranging from direct primary care to
information and referral. Approximately 70% bill for their
services (primarily Medi-Cal and CHDP) but recover only 50%
or less of their total budgets from billing. According to
the California Assembly for School-Based Health Care, there
are approximately 6 to 8 school health clinics located
primarily in San Diego that have contracts with managed
care plans.
SBHCs are organized in a variety of ways: a school-based
health center provides an outside physician or nurse
practitioner on the school site; a school linked health
center provides a school nurse on the school site who
refers to a capitated physician provider for health care
off the school site; a staff model health center provides
either school district or County Health Department
personnel who are physicians or nurse practitioners as
providers on the school site.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
According to the Senate Appropriations Committee:
Fiscal Impact (in thousands)
Major Provisions 2000-01 2001-02
2002-03 Fund
Grants 2,000-4,500
General
Study group Minor costs
General
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This bill previously appropriated $2 million from the
General Fund for the grant program, however, preliminary
estimates from the department indicate that it may take as
much as $4.5 million to assist all of the school health
centers desiring to become qualified, if they apply. The
budget appropriation, if any, would establish the funding
level.
SUPPORT : (Verified 1/26/00)
Los Angeles Unified School District (source)
Alameda County Health Care Services Agency
American Association of University Women
Board of Registered Nursing
California Association of School-Based and School-Linked
Health Programs
California Teacher's Association
Children's Hospital and Health Center, San Diego
Delta Health Care
California School Nurses Organization
3 individuals
OPPOSITION : (Verified 1/26/00)
California Pro Life Council
Citizens Commission on Human Rights (Church of Scientology)
ARGUMENTS IN SUPPORT : According to the Los Angeles
Unified School District, school-based health programs are
an important source of primary and preventative health care
for their students. The district indicates that the health
centers which are developed in collaboration with outside
health care providers, receive over 13,500 visits each
school year. They are particularly important in addressing
the health needs of adolescents, who are a traditionally
underserved population. The health programs serve students
regardless of whether they are uninsured or insured through
Medi-Cal or Healthy Families. They also serve to educate
students and their families about the public insurance
programs available to low-income families.
According to the Alameda County Health Care Services
Agency, California is one of the few states with a sizable
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number of school-based health centers that offers no state
support, either in actual dollars or resources and
technical assistance. The convening of a one-year study
group to explore the issue of school health financing is a
first step.
According to Delta Health Care, these centers keep students
in school and foster success, identify students at risk for
violence and substance abuse, and intervene early to
promote a safe and secure environment. The health centers
are a good investment; they help keep children out of
hospitals and emergency rooms, and offer early detection
and prevention.
ARGUMENTS IN OPPOSITION : According to the California Pro
Life Council, Inc., when health services are provided in
the schools, the important element of parental oversight is
virtually always lost or at best indirect (by use of
blanket consent forms), which is risky in the case of many
services. In the case of so-called "reproductive health
services," which often include birth control counseling and
prescriptions, and abortion counseling and referrals, state
court decisions prevent the schools from obtaining parental
consent.
Several legal opinions of long-standing, including that of
Legislative Counsel, indicate that if comprehensive
health-care is offered, it would be unconstitutional to
exclude birth control or abortion counseling and
services--though California Pro Life Council, Inc. states
that they nevertheless recommend that parents attempt to
obtain these exclusions wherever health services are
provided in elementary and secondary schools.
The California Pro Life Council, Inc. also states that this
bill promotes enrollment in the Health Families Program,
which is not being property implemented in California.
Congress expressly prohibited purchase of health insurance
policies that include abortion services.
CP:jk 1/27/00 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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